A charley horse is a colloquial term that is very broadly used to describe cramping or spasm pains in the leg muscles. However, it also specifically refers to a condition known as “dead leg” or quadriceps contusions, an injury that simply means bruising of the quadriceps muscle.
Quadriceps Contusion (Charley Horse)
Quadriceps Anatomy
The quadriceps is a large muscle group, rather than a single large muscle. The group is comprised of four muscles - the rectus remoris, vastus medialis, vastus intermedius and vastus lateralis. The four muscles are located on the anterior aspect of the thigh. The rectus femoris originates from the pelvis and crosses the hip joint. The remaining muscles originate at the top of the femur and attach to the anterior tibia. Each muscle of the quadriceps work together to extend the lower leg.
Quadriceps Contusions / Charley Horse
The contusion type of charley horse is the result an a direct blow to the thigh (contusion) that results in the muscle bruising, tightening, and unnaturally contracting.
What Causes A Contusion Type Charley Horse?
This occurrence is common in contact sports, where a blow to the thigh area crushes the quadriceps against underlying bone. However, the injury can occur during “horsing around” (rough and rowdy play) or from a fall that strikes the thigh on an object.
Contusion Type Charley Horse
There are two types of contusions:
Intramuscular - the muscle is torn within the surrounding sheath. The bleeding causing the contusion will usually stop within a few hours, but is unable to escape the intact muscle sheath.
Intermuscular -the muscle and the surrounding sheath are torn. The bleeding that is causing the contusion will last longer. The damaged sheath allows the blood to escape into surrounding tissue.
Symptoms Of A Quadriceps Contusion
The amount of force causing the injury and how relaxed the quadriceps were at the time of impact determines the degree of symptoms. All muscle contusions are broken down by a grading system of one through three, with a list of symptoms that usually accompany each degree of injury.
Grade I - minor capillary rupture and bleeding
* usually intramuscular
* quadriceps tightness
* mild to no swelling
* mild pain that may worsen with trying to extend the affected leg
* limited if any bruising
Grade II - moderate capillary rupture and bleeding
* usually intermuscular
* moderate quadriceps tightness
* moderate pain
* may have difficulty extending the leg and inability to fully extend the leg
* tenderness over the quadriceps
* moderate swelling
* moderate bruising
Grade III - significant capillary rupture and bleeding
* intermuscular contusion
* inability to place weight on affected leg
* immediate and severe pain, swelling, and bruising
* thigh area may be severely painful to the touch
* may feel a bulge or hard knot on the muscle
Complications
One common complication of an intermuscular quadriceps contusion is myositis ossificans traumatica, which is a calcification of a portion of the injured quadriceps muscle involved. This calcification involves bone growing within the muscle around two to four weeks post-injury and is very painful.
Strengthening Exercises
These Quadriceps Exercises are ideal to build strength and flexibility.
Massage Treatment
These Quadriceps Massage Techniques are of great value in pain relief; circulation stimulation; dispersing blood and fluid accumulations; swelling reduction; and relaxing muscle spasms, especially when used alongside the Sinew Therapeutics liniments and soaks.
ACUTE STAGE SYMPTOMS AND TREATMENT
This stage is characterized by swelling, redness, pain, and possibly a local sensation of heat, indicating inflammation. If coolness makes your pain feel better, then the Acute Stage Treatment is recommended.
ACUTE STAGE SYMPTOMS:
The acute stage starts the moment an injury occurs and lasts until the swelling and inflammation are gone. The swelling is the result of the blockage of blood, tissue fluids and circulation in the quadricep because their normal movement has been disrupted by the force of the injury. Just like cars back up behind a traffic jam, causing congestion, exhaust and overheating; blood and fluids back up behind the injured quadricep, causing pain, inflammation, lumps and swelling.
The sensation of heat is due to the warming action of the blood and fluids overheating in the injured quadricep as they back up and accumulate. Stiffness and decreased mobility are due to spasms in tendons and ligaments that have contracted reflexively beyond their normal range from the impact of the injury.
As ligaments and tendons stretch and tear, blood from ruptured blood vessels becomes trapped in the local tissues. As the trapped blood clots up, it sticks the tissues together creating adhesions. Adhesions cause pain, inflammation and restricted movement because the layers of tissue that used to slide smoothly across one another now adhere and snap which interferes with normal functioning. It is essential to break up clotted blood as quickly as possible to prevent adhesions and scar tissue from forming.
During the acute stage it is very important to restore normal circulation to the quadricep, break up clotted blood and stagnant fluids, reduce swelling, and reduce the redness and heat associated with inflammation. By restoring the flow of blood, fluids, and circulation in the quadricep, then pain is relieved, damaged tissues can regenerate with healthy functional tissue, and the quadricep can strengthen and regain it's mobility.
ACUTE STAGE TREATMENT:
1. Apply the Sinew Herbal Ice on your quadricep to reduce redness, swelling, and inflammation while dispersing accumulated blood and fluids to help restore normal circulation to the quadricep. This first-aid treatment is used in place of ice to significantly speed up the healing process. It reduces the swelling and inflammation more effectively than ice, allowing you to more quickly regain range of motion. Acute Sinew Liniment can be used in-between applications.
Ice is not recommended because it does not help repair damaged tissues and keeps everything in the injured area frozen, causing the stagnation of blood and fluids and the contraction of muscles, tendons and ligaments. In Chinese sports medicine ice is not used and is considered a culprit in injuries that don’t heal well.
2. Massage your quadricep with Acute Sinew Liniment to relieve pain, reduce swelling and inflammation, break up clotted blood and stagnant fluids, and stimulate circulation of blood and fluids to help cells quickly repair damaged tissues. Sinew Herbal Ice can be used in-between applications.
3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.
CHRONIC STAGE SYMPTOMS AND TREATMENT
This stage begins once the swelling and inflammation are gone, but you still feel pain, stiffness, weakness, and/or sensitivity in cold and damp weather. If heat makes your pain feel better, then the Chronic Stage Treatment is recommended.
CHRONIC STAGE SYMPTOMS:
The chronic stage begins once the swelling and inflammation are gone, but you still feel aching pain and stiffness. This is because there are still accumulations of stagnant blood and fluids in your quadricep that are blocking circulation and blood supply to damaged tissues, creating residual pain, stiffness and weakness. You may actually feel hard nodules like sand in the tissue, indicating accumulation, calcification, and adhesions, which all cause pain, stiffness, and joint instability.
Your quadricep may feel more sensitive to the cold and ache in cold and damp weather due to impaired circulation. When you move your quadricep you may hear a clicking or popping sound from the tendons and ligaments slipping very slightly in and out of their natural alignment indicating weakness and joint instability, causing chronic pain and a cycle of reinjury. These symptoms are often the result of failure to treat the injury properly from the outset and overicing.
Increasing circulation and blood supply to the damaged tissues is very important in treating chronic injuries because tendons and ligaments do not have an extensive direct supply of blood. That is why chronic injuries can be slow to heal. Increasing local circulation also prevents cold and dampness from penetrating the injured area, preventing pain and stiffness.
During the chronic stage it is very important to break up remaining accumulations of blood and fluids, and increase circulation and blood supply to the damaged tissues. By increasing circulation and blood flow in the quadricep, then pain and stiffness is relieved, and the tendons and ligaments can strengthen to restore stability.
CHRONIC STAGE TREATMENT:
1. Massage your quadricep with Chronic Sinew Liniment to relieve pain and stiffness, strongly stimulate circulation and blood flow to damaged tissues, and promote the healing of overstretched tendons and ligaments. The Sinew Relaxing Soak can be used in-between applications.
2. Soak your quadricep with the Sinew Relaxing Soak to relax muscles and tendons that are in spasm, ease joint pain and stiffness, and improve range of motion. The Sinew Relaxing Soak is particularly useful if you feel tightness in your quadricep. The soak can be used by saturating a towel in the liquid and applying it to your quadricep. Chronic Sinew Liniment can be used in-between applications.
3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.
